Which observation is consistent with ACE inhibitor therapy such as captopril?

• A. Dehydration
• B. Hyperglycemia
• C. Persistent cough
• D. Peripheral edema

Answer: (D)

ACE inhibitors raise bradykinin levels, which leads to vasodilation and a lower blood pressure, but a notable side effect is a persistent dry cough caused by bradykinin irritating the airways. This cough is a classic, well-recognized observation with this class of drugs and often prompts a change in therapy if it becomes bothersome.

Dehydration isn’t a typical direct effect of ACE inhibitors themselves (though volume depletion can occur with diuretics or in certain settings). Hyperglycemia isn’t a characteristic effect, and peripheral edema is not expected as a result of ACE inhibitor therapy; these findings don’t reflect the usual pharmacologic action of ACE inhibitors.

So the observation that best fits ACE inhibitor therapy is a persistent cough due to bradykinin accumulation.